06090152 k8015
TY OF CIIPERTINO 'i
BUILDING DIVISION CONTRACTOR ,N,EORMAT=ION
PERMITx:, ti.,...e ..__ .d _ :,rig ,. x.• r
DING AD DRESS: RIGHT ROOFING PERMIT NO.O6090152
RAINBOW DR
ER'S NAME: PERMIT ISSUE DATE
HARTING STEPHEN 467 SARATOGA AVE 09/19/2006
NE: SANITARY NO, CONTROL NO.
(408) 254-4439
ARCHI'IECTYENGINEER: BUILDING PERMIT INFO
BLDGELECT PLUMB MECH
0 L 0 0
�w0 LICENSED CONnRd under
DECLARATION Job Description
1 Wrcby affirm that 1 am licensed unJcr provisions a(Chapmr Y(commcndng
?inti wiOSecdonlOW)of Divldon3ofthe Budn=v dProfessiow Code,andmylicenmis
i.faaxm force der _ REROOF— REMOVE SHAKES INSTALL 1/2" PLYWOOD, 30
Licenx Lic.g FELT, PRESIDENTIAL COMP 33 S ARES, CLASS A
�y,W Dale Comment,4'/ Ha(( , QWWW
ARCHITELTS pEC blit r f mmis r=./
1wU understand my plans Old[E TR ill public ATION
.Q��
LiccnscJ Pmfcssianal /
OWNER-BUILDER DECLARATION
CC I herebyaso alum then 11. exempt from the Cssions o :Any c law for Ne
O o following reason.(Section]03 Ln Business end ere,d,rom Calc:Any city of county
S$(L which¢quires a permit m eaesuuec alba improv,h Kmiit or pan any s mcnI
_Zy pian us its issuanm.also nequims the applicant formch permiva dM asigncd sulemcm
[4c UalhcaliccnxJpunuentto0epmvisiansofNCConuslarYL'acre¢taw(Chaptcr9 Sq.F[. Floor Area Valuilr1000
Yt- (commcncing wish Scction?")of Division 3 ofthc Businessland Professions Carlo)or
m 5$— Out he is exempt therefrom and the,basis for the alleged exempdom Any violation of
Section 7031.5 by my applicant for a permit subjects On applicant to a civil penalty of qPN Number Occupancy Type
B.ehundreddollars(s5W). 36
act mom than five P y yp
❑I,u.want of the property,m my employers with wags as their sola mmpervxdmi
will do dm work,and deamneCWR is at Nlaodcd MaR[md far aide(Sec.IDN.BudnCSt Required Inspections
sen prolamines Code:The Communes License Law docs ant apply w u e ns owner of q P
property who builds or improves themem,and who doessuch work himselforthrough his
own cmployms,provided than such improvements arc not intended oronered forsale.If.
however.are Wilding or improvement is sold within arc year of completion.the owner.
Wilder will have tW home.of proving that he did not Wild or improve far purpose of
rale).
1,as owner.(ft Property an exclusively connecting with licensed¢macron m
construct the pri(Sec.7W.Business and Professions Cade:)The Comalme is U.
tante Law does not apply in an owner of property who Wilds or improves th mon,and
who contracts for such Projects with a conneexi licensed pursuant to the Commcut's
Lke.Law.
❑1 am exempt under Sec ,B&P C for this reason
Owrmr Data
WORKERS COMPENSATION DECLARATION
I hereby M.under penalty,of perjury one or Ne following declanumns:
1 haw and will mdnum aCuuGcassof Ci mem w self-inmm fm WarkefaCmirem-
sation.as provided for by Section 37W of Nr Labor Code.for the Performance:of On
work for which this permit is issued.
❑ I Mme and will maintain Worker's Compensation Inwmnce,as required by Sermon
3700 of the Labor Code,for the performance of the wart for which this permit is issued.
My Worker's com,pensadon Insurance carrier and Policy number-am:
Carer4',r AWOFA Policy No.: /T -
CERTIFlCATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu section need not W complcmJ if the permit Is future hundred dollen(5100)
or Icar)
I certify On,in dee performance of the work for which this Permit is issued,l shall not
employ,any person in any manucrso as to become subject to the Workerl'Compenradan
Laws of California.Dau
Applicant
NOTICE TO APPLICANT:If,aper making Nis Cenificam of Exemption,you should
become subject in the Workces Compcnmtion provisions of the tabor Code,you mus
,J O faMwiN comply with such Provisions w Nis permit$ball be raveled.
nked.
E"i CONSTRUCTION LENDING AGENCY
[-a.�+ I Wmby,strums that Nem is a construction lending agency,far dre indarmamnof
!Y the work,for which this Permit u issued(See,309'7,Civ.C.)
GQ Lender's Name
.7 z Larder Addmsv
U O 1 certify that I haw read this application and mule Nat the above information is
" comet.I agree to comply with all city and county collimators and suite laws relating 10
CD building conswction.and hereby authorim representatives of Nis city to enter upon the
W abowcmcjudgir aropc costs
fard inspection purposes.
F LL (We)agme to sew,indcmnrfy and keep harmless da City of Cupcnino against
h incoisequer ,oftheeosuand ex this Psmit. may in any way eccme against mid City
V z APPLICANTcUNDERSTAN gamfing of thislR WILL COAAAyyy ITH ALL NOpI- Olpppffffff Issued by: Date �. C
SOURCEREGULAT NS. / / /
/// / /T7///tom/b / Re-roofs
Stgnatum of Apph��AR O�S MATERIALS ISCLOSURE Type of Roof
Will Nc applicant or fumes building occupant store or handle hvamous melerial
as defined by the Cupertino Municipal Cade.Chapter 9.12.and the Health and Safety
Cade.Section 25532(.)?
t]Ycr Nu All roofs shall be inspected prior to any roofing material being installed:
Will the applicant or future Wilding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
.mit hanmous air conceminam s u dchned by the Bay Area Air Quality Management all new materials for inspection.
District?
p Yes 4Nu
I have mil the hvamms materialsrequimmem,under Chapmr6.95 of the Califon
ria Hualth&Safety Coda Sredons25bO5,25533md25534.1undcmand thmif dle Wilding
Jura net currently his len chat Itis my mihilitYmnoul'ydc up of Nc
¢ahem cnuwhit tprior ofa Clilytonof ry
Signature of Applicant Date
Owner s sutb ,. t D,le All roof coverings to be Class "B"or better
CITY OF CUPERTINO
�m 2 of 2 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36211046 . 00
DATE ISSUED. . . . . . . : 09/19/2006
RECEIPT # . . . . . . . . . : 36114
REFERENCE ID # . . . : 06090152
SITE ADDRESS . . . . . : 8015 RAINBOW DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : HARTING STEPHEN
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . . ,
RECEIVED FROM . . . . : RIGHT ROOFING
CONTRACTOR . . . . . . . : LOSTRIE, JEFFREY LIC # 20696
COMPANY . . . . . . . . . . : RIGHT ROOFING
ADDRESS . . . . . . . . . . : 467 SARATOGA AVE
CITY/STATE/ZIP . . . : SAN JOSE, CA 95129
TELEPHONE . . . . . . . . : (408) 254-4439
*EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- -------- --
BPERMFEE VALUATION 14 , 000 . 00 2.12.. 76 0 . 00 212 . 76 0 . 00
BSEISMICRE VALUATION 14 , 000 . 00 1 .40 0 . 00 1 . 40 0 . 00
BUSLIC FLAT RATE 1 . 00 105 . 00 0 . 00 105 . 00 0 . 00
--------- - -- -------- ---------- --- - ------
TOTAL PERMIT 319 . 16 0 . 00 319 . 16 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
-- --- - ------ - - - -- ------------ ------------- - - - - -
CHECK 522 . 42 3484
TOTAL RECEIPT 522 . 42
se
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY Of Fax(408)777-3333
�UPEkTINO
Building Department
JOB ADDRESS: ,J �� PERMIT #
koNIA) 06� X61 s- 2
OWNER'S NAME: Int ffgLhLAf PHONE # 2 -V L
GENERAL CONTRACTOR h FAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information
60 SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum/ Wood
• Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing — 7�Ar 0(P d44�1/-)CIAA jear 0
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/ tractooiature ate
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
. Telephone: (408)777-3228
Fax: (408) 777-3333
Building Department
Subject: Re-roofing policy for the City of Cupertino
1. Prior to permit issuance,you must agree to comply with 1997 UBC Standards
and manufacturers specifications on re-roofing.
2. New roof coverings shall not be applied without first obtaining all inspection
and written approval from the building inspector. A final inspection and
approval shall be obtained from the building inspector when the re-roofing
is completed.
3. All roofs shall be inspected prior to any roofing installation.
4. To receive a final sign off from the City, the following steps are
required:
1) Pre-inspection and/or tear off approval.
2) In-progress inspection approval.
3) Final inspection approval.
a) Spark arrester installation.
5. If plywood is installed, a plywood nail inspection is required.
• 6. Any roofing which is applied without first obtaining an inspection,
will require the removal of all new material down to the sheathing,
so a proper City inspection can be performed.
7. NOTE: If you call for a plywood nail inspection and the job is not ready,
you will be charged a re-inspection fee of$176.18. The re-inspection fee must
be paid before another inspection can be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of 1/4 " per foot slope and demonstrate
that there is no ponding.
2. An I.C.B.O. report is required to be on the job site at the time on inspection.
I understand and will comply with the above stated policy on re-roofing.
Homeowner's Name: _.r Cv-e ATTV h
Job Site Address: Qty 1Y lltRi1L�0
Roofing Company Name: &`l 1
Applicant's Signature: Date: (�
Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO
REROOF
• CUQfINO PERMIT APPLICATION FORM
APN# n 1 n � I I — III ^ Date:
Building Address: /✓—lY ` ]l(J
Sacs �Q,kdd�
Owner's Name: Phone #:
Contractor: License#:
Contact: Cupertino Business License #:
ZoS lr Yo 2Y2-/6
-71 Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles Asphalt Shingles
Wood Shakes ❑ Wood Shakes
Wood Shingles ❑ Wood Shingles
Other(Specify) ❑ Other(Specify)
Number of existing coverings i ❑ Provide I.C.B.O. Report#
YL To be Removed / ❑ Provide Mfgr. Installation Specs.
• I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Description: )�
1
p /V� . oa ll r S / e� ro 33
Residential ommercial ❑ Ntcyco
Fire Zone: Yes C3No Confirmed with Planning Dept. if
there are any restrictions: LJ
Cost of Project: Type of Construction: Occupancy group:
Qty. if
Applicable Fee lD Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Energy BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING